The role of imaging in patient selection for epilepsy temporal lobe surgery.
| Abstract: |
- Background: Temporal lobe epilepsy is the most common form of the focal epilepsies and can have a wide range of underlying aetiologies. In several cases, seizures are refractory to best medical management, with a proportion of these patients being suitable for some form of temporal lobe surgery with the scope of ablating their seizures. Successful surgical outcome is dependent on accurate patient selection for surgery. Imaging plays a large role in determining candidacy for surgery by demonstrating a presumed epileptogenic focus. The purpose of this article is to assess the different imaging modalities that are used in the preoperative workup of patients being considered for temporal lobe resection.
- Methods: The mainstay imaging techniques were reviewed and the evidence for their use in the literature was explored.
- Results: The outcomes of this review strongly suggest that MRI should form the basis of preoperative imaging protocols, however, it also highlighted the need for a more stratified protocol of the other imaging modalities (SPECT, PET, MRS) when MRI fails to demonstrate any structural abnormality.
- Conclusion: The role of more advanced techniques such as fMRI, perfusion MRI and diffusion MRI were also evaluated for their use in preoperative assessment of patients.
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| Imaging keywords: |
- Magnetic resonance (MR)
- Functional magnetic resonance (fMR)
- Magnetic resonance perfusion (MRP)
- Magnetic resonance diffusion (DWI)
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| Application / disease keywords: |
- Epilepsy / seizure
- Epilepsy, temporal lobe
- Surgery, epilepsy
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